Nurse aides in Zimbabwe are advocating for legislative reforms to address their poor working conditions and lack of recognition within the healthcare system.
They highlight critical challenges, including the absence of proper uniforms, vague job descriptions that leave them vulnerable to exploitation, and exclusion from donor allowances provided to registered nurses.
This disparity was particularly evident during donor-funded initiatives, where nurse aides, despite their direct involvement in healthcare delivery, were left out of benefit schemes.
Their plight was highlighted in a report compiled by the Parliamentary Portfolio Committee on Health and Child Care, in which the Nurse Aides Association of Zimbabwe Trust (NAAZT), a registered trust representing nurse aides and advocating for their recognition as healthcare professionals, petitioned Parliament to pass a Nurse Aides Council Act.
The Nurse Aides Council Act would establish a governing body to regulate the profession, craft binding policies, and make sure there is adherence to professional standards.
The proposed council would also address grievances, regulate wages, and improve working conditions.
According to the committee, nurse aides across the country expressed strong support for this initiative, emphasising the need for legal representation and accountability.
“NAAZT stressed that nurse aides working under the MoHCC face serious discrimination, for instance, lack of representation during negotiations over working conditions. In addition, nurse aides were not entitled to uniforms. Furthermore, they were operating without a job description resulting in abuse at work stations,” read the report.
“In circumstances where there was donor funding, nurse aides were not enjoying the same benefits as registered nurses. These sentiments were also shared during public hearings. It was NAAZT’s view that whilst nurse aides were directly involved in the delivery of health services, they were not receiving donor allowances like other health workers.”
The committee highlighted how nurse aides performed various duties including; feeding and bathing patients, administering medication, run errands, but they were not considered for donor allowances, which other professionals such as registered nurses and primary health care nurses were currently enjoying.
The committee noted how these challenges reflect deep-rooted inequalities in the treatment of nurse aides, who are an integral part of the healthcare delivery system.
The Ministry of Defence and other stakeholders supported the creation of a Nurse Aides Council, arguing it would bring order to the profession, improve public confidence, and enhance healthcare outcomes.
A council could also serve as a voice for nurse aides, advocating for better working conditions, ethical standards, and professional accountability.
The committee also raised alarm over the “mushrooming” of unregulated Nurse Aides Training Schools, questioning the quality of training provided.
“Although the MoHCC had no responsibility over the Nurse Aides Training Institutions, keeping a blind eye was exacerbating the disorder,” said the committee which underscored the importance of recognising nurse aides as an essential component of Zimbabwe’s healthcare system.
“Nurse Aides are the first point of contact at a hospital/clinic and are generally recognised by the patients as part of the health service delivery system. In the first world, nurse aides were regarded as caregivers and caregiving is a huge industry that is regulated, especially in the developed countries.”
The Health Professions Authority of Zimbabwe (HPAZ) argued nurse aides are not classified as health professionals under the Health Professions Act, citing their historical origin under the Zimbabwe Red Cross Act.
HPAZ maintained nurse aides are “general hands” assisting qualified medical professionals, a stance echoed by the MoHCC.
“The lowest grade in the health sector was identified as the Primary Care Nurse (PCN), whose duration of training was 24 months, whereas nurse aides ranged from a few days to 3 months. HPAZ observed that historically, the Nurse Aides were a product of the Zimbabwe Red Cross Act which is administered by the Ministry of Defence, in line with the Geneva Conventions on the management of armed conflicts,” read the report
“However, they argued the Red Cross Society orientation did not produce a health professional who could be registered under the Health Professions Act. Hence, HPAZ maintained its position that Nurse Aides cannot be considered as health professionals who need to be regulated as such.”
The Ministry of Defence presented a contrasting view, asserting a council could improve the quality of care provided by nurse aides and bring professionalism to the role.
The committee alluded to the Permanent Secretary in the Ministry of Health and Child Care, Dr Aspect Maunganidze, who acknowledged the challenges faced by nurse aides but argued existing structures, such as the Tripartite Negotiation Forum, sufficiently represented their interests.
However, public hearings revealed a different picture, with nurse aides decrying their exclusion from critical decision-making processes and the lack of regulatory oversight.
“Through legal representation, the Council would resolve grievances among Nurse Aides. In addition, nurse aides’ salaries and wages would be properly addressed and regulated,” said the committee.
“With a governing body, there could be regular oversight and evaluation of nurse aides, helping in maintaining high standards and addressing any cases of misconduct or incompetence.”
